Comparison of T2-Weighted 3D-Space and T2-Weighted 2D-TSE Sequences in Lumbar Spine Magnetic Resonance Imaging (MRI)

Abstract

Background: Spine-related issues like low back pain have substantially increased in the past few decades across all age categories having various reasons. Objectives: To compare the image quality and diagnostic value of 3D space MRI sequence with 2D TSE MRI sequence in lumbar spine imaging. Methods: Fifty patients, irrespective of gender having age between 30-70 years, who presented with lower back pain were enrolled for the study. Lumbar spine imaging was done using 2D TSE and 3D space sequences and the subsequent images were evaluated by two senior consultant radiologists for qualitative analysis of visibility and pathologic indices of both sequences. Data was analyzed on SPSS 25.0. Statistical analysis was done using Cohen's kappa (k). Results: Female participants were 56% of total study population. Mean age of study participants found to be 53.62±10.76 years. Statistically significant difference (p-value =0.000) was noted for visibility score of all the lumbar spine components, when the 3D SPACE and 2D TSE images were compared with 3D-SPACE images found being superior in visibility. Inter- observer agreement for visibility of various regions of lumber spine was nearly perfect (k> 0.8) and substantial (0.6 to 0.8) for 3D-SPACE, while substantial (0.8<k> 0.6) for 2D-TSE. Pathologic indexes had a significant level of inter-observer agreement (k > 0.6). Inter-observer agreement for 3D sequence (k = 0.72) was greater than that for 2D-TSE sequence (k = 0.64). Conclusion: Images from 3D-SPACE sequences provide superior visibility over 2D-TSE and could be recommended as alternative imaging method for lumbar spine pathologies. Higher inter observer agreement illustrate that it may be included in routine sequences to make the better diagnosis for lumbar spine pathologies correctly.